First 3 Weeks of Readings For Nursing III Fall 2013
These readings have been chosen to give you an overview of the scope and practice of caring for
the growing family.
NOTE: The Critical Concept review at the end of each chapter.
INTRODUCTION - THE FAMILY: INTIMACY VS. ISOLATION (1/16) Week one.
Readings:
London
Introduction to Maternity Nursing:
Chapters 1; 2; 3; 5 (pgs. 104-105), chapter 10 (pgs. 200-213)
* The understanding of key prenatal and labor and delivery concepts are necessary in order to
facilitate postpartal family care.
I. Baseline Data
a. Definitions of terms
1) Antepartal
2) Intrapartal
3) Postpartal
4) Gravida
5) Parity
6) Gestation
7) Term
b. Anatomy and Physiology (overview)
1) Internal and external reproductive organs
a. breasts and nipples
b. uterus
c. perineum
d. rectum
II. Nursing process
a. Assessment data
1) Client history/profile
Maslow hierarchy of needs
Risk assessment
2) Physical assessment
3) Pertinent prenatal lab tests and data
4) Determination of length of gestation
5) Labor data
6) Method of delivery
Analgesia
Anesthesia
b. Data Analysis: Common Nursing diagnoses
1) Actual
2) Risk
3) Wellness
c. Expected outcome statement for family
d. Interventions with rationales
1) Evidence-based standards
e. Evaluation
-19-
OUTLINE FOR INTRODUCTION TO THE CARE OF THE GROWING FAMILY:
I. Baseline data
A. Current issues in maternal-newborn care
B. Statistics related to families/mortality and morbidity
C. Social and cultural issues
II. Nursing process
A. Assessment: data collection - needs assessment associated with the following:
1. Social, cultural and religious influence on the child
2. Family structure
3. Major trends in growth and development
4. Communication with children
5. Overview of current perspectives in maternal-newborn nursing:
a. Nursing roles and standards of care
b. Legal and ethical aspects
c. Biomedical technology
B. Data analysis:
1. Ineffective coping R/T role change
2. Altered family processes R/T birth of newborn
3. Altered role performance R/T change in roles
C. Expected outcomes
D. Nursing interventions and rationale
E. Evaluation
THE POSTPARTAL FAMILY: NEEDS OF THE NEWBORN (1/16) Week one.
Readings:
London
Chapters 24; 25; 26; 27; 34 (pgs. 895-901)
Refer to appropriate drug classifications relative to this area.
OUTLINE
I. Baseline data
A. Normal growth and development
1. Biologic
2. Psychosocial
3. Cognitive
B. Physiological response to birth
C. Psychosocial and cultural factors
D. Terminology
-20II. Nursing process
A.
Assessment: data collection
1. Diagnostic tests
2. Laboratory data
3. Needs assessment of the normal newborn:
a. Apgar score
b. Gestational age assessment
c. Physiological adaptations
(1) Vitamin K
(2) Eye care
(3) Cord care
(4) Physiologic jaundice
d. Neurological status
e. Behavioral patterns
f. Oxygenation
g. Temperature control
h. Sleep
i. Nutrition
j. Prevention of infection
k. Newborn screening (PKU)
l. Allergic response
(1) Diaper rash
(2) Cradle cap
m. Parent education
(1) Handling
(2) Bathing
(3) Wrapping
(4) Dressing
(5) Feeding (breast and bottle)
(6) Elimination
(7) Circumcision
(8) Safety
(9) Vaccines
(10)When to call pediatrician
(11)Cord care
n. Maternal-infant interaction
B. Data analysis: common nursing diagnoses
1. Ineffective airway clearance R/T mucus obstruction
2. Ineffective thermoregulation R/T hypothermia secondary to inadequate subcutaneous
tissue
3. Risk for alteration in tissue perfusion R/T decreased body temperature
4. Ineffective feeding pattern R/T poor sucking reflex
5. Ineffective family coping R/T birth of potentially ill newborn
C. Expected outcomes
D. Nursing interventions and rationale
E. Evaluation
-21THE POSTPARTAL FAMILY: NEEDS OF THE POSTPARTAL CLIENT (1/16)
week 1 Readings:
London
Chapters 22 (pgs. 518-522); 30; 31
Refer to appropriate drug classifications relative to this area.
I.
OUTLINE
Baseline data
A. Physiology (review)
B. Psychosocial and cultural factors
C. Terminology
D. Risk factors
II. Nursing process
A. Assessment: data collection
1. Diagnostic tests
2. Laboratory data
3. Needs assessment of a postpartal client:
a. Physiological needs
(1) Oxygen
(2) Fluids and electrolytes
(3) Nutrition
(4) Elimination
(5) Activity and exercise
(6) Comfort (NOTE: Drug Guide - Postpartum Epidural Morphine, p. 607)
(7) Vaginal vs. Cesarean delivery
b. Safety and security needs
(1) Discharge teaching - self care, danger signs
(2) Discharge teaching – parenting
c. Love and belonging needs
(1) Parent-infant bonding
(2) Resumption of sexual activities/contraception
(3) Role integration
d. Self-esteem needs
(1) Family wellness
(2) Postpartum "blues"
-22B. Data analysis: common nursing diagnoses
1. Self care deficit R/T knowledge deficit secondary to normal
psychological changes in postpartal period
2. Altered comfort R/T to episiotomy, sore nipples, breast engorgement, hemorrhoids
3. Anxiety R/T change in role function
C. Expected outcomes
D. Nursing interventions and rationale
E. Evaluation
POSTPARTAL FAMILY AT RISK
NEEDS OF THE POSTPARTAL CLIENT AT RISK
week 2
Readings:
London
Chapter 23 (pgs. 521-527); 32
Vacarolis
Chapter 18
(1/23)
Refer to appropriate drug classifications relative to this area.
OUTLINE
I. Baseline data
A. Physiology (review)
B. Psychosocial and cultural factors
C. Terminology
D. Risk factors
II. Nursing process
A. Assessment: data collection
1. Diagnostic tests
2. Laboratory data
3. Needs assessment of a client with postpartal complications:
a. Alterations in oxygenation
(1) Hemorrhage
(a) Uterine atony
(b) Retained placenta
(c) Hematomas/lacerations
(d) Subinvolution
(2) Thrombus formation
b. Alterations in safety
(1) Postpartum infections
(2) Mastitis/Endometritis
(3) Substance abuse
(4) Postpartum depression
(5) Postpartum psychosis
B. Data analysis: common nursing diagnoses
1. Altered peripheral tissue perfusion R/T interrupted venous flow
2. Fluid volume deficit R/T excessive bleeding
3. High risk for infection R/T tissue trauma
4. Risk for altered parent-infant attachment R/T hormonal imbalances
-23C. Expected outcomes
D. Nursing interventions and rationale
E. Evaluation
THE POSTPARTAL FAMILY AT RISK
NEEDS OF THE NEWBORN AT RISK (1/30)
week 3
Readings:
London
Chapters 28; 29; 47 (pgs. 1278-1281)
HIV: Vertical Transmission (p. 698)
Refer to appropriate drug classifications relative to this area.
OUTLINE
I. Baseline data
A.
B.
C.
D.
Physiology (review)
Psychosocial and cultural factors
Terminology
Risk factors
II. Nursing process
A. Assessment: data collection
1. Diagnostic tests
2. Laboratory data
3. Needs assessment of the high risk newborn:
a.
b.
c.
d.
e.
f.
g.
h.
Abnormal gestational age or size
Nutrition
Infant of a diabetic mother
Respiratory distress syndrome, retinopathy of prematurity (ROP)
Cold stress
Hypoglycemia
Hypocalcemia
Jaundice/kernicterus/hemolytic dysfunction/RH sensitization
i. Neonatal infections
(1) Sepsis
(2) TORCH infections
j. Necrotizing enterocolitis.
k. Newborn resuscitation
l. Cardiac defects
m. HIV in infants
n. chemical dependence
-24B. Data analysis: common nursing diagnoses
1. Impaired gas exchange R/T respiratory distress secondary to
surfactant deficiency
2. Risk for alteration in nutrition, less than body requirements
R/T limited intake
3. High risk for injury to CNS involvement R/T electrolyte imbalance
C. Expected outcomes
D. Nursing interventions and rationale
E. Evaluation